San Diego, CA. The War in Iraq remains a hot button issue among politicians and the public but recent national polls have shown that the problems of the uninsured have jumped to the top of the domestic political agenda in Washington and on the campaign trail – much ahead of immigration or cutting taxes. The “surge” is timely considering the following statistics: about 47 million Americans today lack health insurance, up from about 40 million in 2000. A staggering 17 million of the nearly 47 million — have family incomes of $40,000 or more, according to the Employee Benefit Research Institute, a nonpartisan organization. More than two- thirds of the uninsured are in households with at least one full-time worker.

        Meanwhile, the costs of healthcare for those who are insured have gone up steadily and the ranks of the uninsured have been swelling; U.S. federal figures show an increase of 6.8 million since 2000.

        But the surprise is that the uninsured are not necessarily the poor, the unemployed and the undocumented. Solidly middle-class people are one of the fastest-growing subgroups among the uninsured.

        In California , more than six million people are without a health insurance. In San Diego , almost 400,000 county residents still are living without any health insurance, and the squeeze on the middle class is getting worse. According to a Center for Policy Initiatives report published early this year, middle-income working adults in San Diego County continue to lose health insurance coverage despite a drop in the total number of uninsured.

        Clearly, our health care system is a mess. We are in the middle of a healthcare crisis and help, it would seem, is still elusive.

        The California State Legislature passed Senate Bill 840 last year but was vetoed by the governor. The bill which was sponsored by Sen. Sheila Kuehl would have provided universal health coverage for every resident of California , regardless of their ability to pay. The governor opined that the bill “would create a big government bureaucracy.”

        Bu the good senator from Santa Monica is undeterred and has re-introduced her bill, with the same number - Senate Bill 840 titled the “California Health Insurance Reliability Act” (CHIRA). Hundreds of consumer, labor, civic and faith-based organizations are rallying together to support the bill. Insurance companies and brokers and chambers of commerce are lining up against it.

        In National City, the Filipino American Community Empowerment (F.A.C.E.) and the Kalusugan Community Services (KCS) is collaborating with the local chapter of “One Care for All” to bring the public into the debate by sponsoring a community forum on March 24 at the KCS Wellness Center on 8th Street in National City, from 10 o’clock in the morning until noon.

        With the health care costs continuing to spiral out of the financial reach of average citizens, I believe that it is time that something like what Senator Kuehl is proposing to be adopted here in California .

        The governor himself is proposing his own health care reform agenda which is rather a very complicated plan. Not to be outdone, President Bush is also selling the idea of health savings account which in the guise of providing greater consumer choice create a confusing array of alternatives that disguise a further reduction in coverage and more cost-shifting away from the young and healthy toward the old and sick.

        With both of them wading into the healthcare reform debate, tells me that it is just a matter of time before other politicians will get in the act and will eventually come up with a compromised bill. The question is will it be the right prescription for the current mess?

        To come up with the right solution I think it is important that policymakers understand that any successful attempt to reform health care must accommodate these realities.

        First and most important, is that the current system is increasingly inaccessible to many poor and lower-middle-class people. Those lucky enough to have coverage are paying steadily more and/or receiving steadily fewer benefits. Meanwhile, the increasingly complex warfare between insurers and hospitals over who pays the bills is gobbling up a great deal of money and resources; and the end result is that we pay more.

        Secondly, open discussion of a “socialized” health care system in which the government pays for and regulates health care is a “no-no” within the political mainstream because it is presumed that Americans would never accept socialized medicine.

        Sen. Kuehl’s proposal is for a government-run, single-payer system providing comprehensive health care benefits for all, financed by taxes and free to patients at the point of service. Her plan would mean a vast increase in the power of government over the health care industry and the way services are planned and delivered.

        Hers is the only proposal on the table that seeks to directly limit the cost of health care. It would do so by setting an annual budget and then enforcing it through negotiations with doctors, hospitals, labs and pharmaceutical companies, or by hiring health plans to provide benefits at a set cost.

        The plan would cover primary care, preventive care, outpatient and hospital care. It would cover mental health, dental, vision, podiatry, chiropractic care, acupuncture, substance abuse and prescription drugs.

        Does this sound too good to be true? Perhaps, but the language of the bill is plain enough to understand that benefits are truly comprehensive. I will encourage the Filipino community to come to this forum to hear more about this plan and how it would be financed.

        Opponents of the bill will again demonize this plan as a socialized medicine scheme – much like what the governor was saying last year and just what the detractors said to Hillary Clinton’s health care reform proposal in 1994. Clinton ’s plan - a sweeping proposed health-care reform that died in Congress in 1994 was not a socialized-medicine scheme but rather an attempt to reorder the private insurance market.

        In the past, we did have good health insurance plans. Blue Cross/Blue Shield Plans and the Health Maintenance Organizations (HMO) schemes were good. As a matter of fact, they were too good that the insurance companies got in the act. Blue Cross and HMOs worked because as non-profits they were able to offer reasonably low premiums.

        But the success of the Blues persuaded commercial insurers, who initially considered medicine an unpromising market, to enter the field. Today employers are reducing or eliminating outright health-care benefits for employees; hospitals are consolidating and becoming less accommodating to low-income patients as they seek to push back against insurers; and most of all, 47 million Americans lack health insurance.

        Insurance companies did a great job to undermine the very idea that the cost of illness should be spread out among the general population, healthy and unhealthy alike. Indeed, they were very successful in shifting the health care burden to the sick people.

        Senate Bill 840 represents hope – we should all support it.